Antibiotic resistance is projected as one of the greatest threats to human health in the future and hence alternatives are being explored to combat resistance. Antimicrobial peptides (AMPs) have shown great promise, because use of AMPs leads bacteria to develop no or low resistance. In this review, we discuss the diversity, history and the various mechanisms of action of AMPs. Although many AMPs have reached clinical trials, to date not many have been approved by the US Food and Drug Administration (FDA) due to issues with toxicity, protease cleavage and short half-life. Some of the recent strategies developed to improve the activity and biocompatibility of AMPs, such as chemical modifications and the use of delivery systems, are also reviewed in this article.

In the pursuit of dendrimer alternatives, hyperbranched polymers have found increasing interest from academia and industry in a broad range of fields due to their topological and synthetic advantages. Hyperbranched polyglycerol (HPG), as the name implies, is a hyperbranched polymer with about 50–65% dendrimeric structure. Due to its ease in synthesis, globular nature, versatility in terms of functionalization, and superb biocompatibility profiles HPG provides a promising class of materials suitable for numerous applications in nanomedicine and biomedical technologies. The structural features of HPG can be easily tailored by adopting different synthetic methodologies. In this review, we briefly explore the synthesis of HPGs starting from the traditional Lewis acid based approaches to recent advances including the development of high MW HPGs, biodegradable HPGs, co-block HPGs and sustainable or ‘green’ HPG synthesis. The robust history of HPG biocompatibility is extensively reviewed giving examples of both in vitro and in vivo models. In particular, HPG showed very minimal polymer accumulation in vital organs after intravenous injection compared to other polymers widely used for various biomedical applications. HPG is well tolerated in mice and rats, and has been found to be non-immunogenic to date. Due to its demonstrated safety profile and multifunctionality, HPG has been extensively studied for different biomedical applications including as macromolecular therapeutics, multivalent inhibitors/scavengers, in controlled drug delivery systems, in organ preservation, dialysis and cell surface engineering, as imaging agents and theranostics, in the development of anti-fouling surfaces and proteomics reagents. We highlight these applications along with its advantages. Finally, we conclude by providing a future prospective of HPG as one of the promising PEG alternatives with a great potential to enter clinical trials in the near future.

In this highlight, we discuss the current strategies for developing infection-resistant biomaterials by making them non-fouling, bactericidal or both. We focus on approaches that have used polymer brush systems by providing examples of hydrophilic non-fouling polymer brushes, those that incorporated bactericidal agents (antibiotics, antimicrobial peptides and proteins) and synthetic polyelectrolyte polymer brushes. We discuss the most important research reported in recent years and deliberate their merits, future potential and further developments required. Initially we give a brief account on the use of anti-adhesive hydrophilic polymer brushes as bacteria-resistant surfaces and their potential utility in short term applications. The importance of the chemistry and physical properties of the brushes is highlighted along with the need for the development of bactericidal coatings. Further, recent developments involving bactericide-releasing and contact killing coatings are discussed. Approaches based on antimicrobial peptide conjugated polymer brushes, those incorporating enzymes (e.g. lysozyme), viruses and chemical functionalities (polyelectrolytes) that can kill bacteria are highlighted. As an important criterion for the in vivo application of infection-resistant coatings, the biocompatibility of the modified surfaces is briefly discussed in each section. The covalent attachment, availability of multitude of functionalities for further modification, ability to alter the physical structure of the coating, biocompatibility, potential application to various biomedical surfaces and the robust mechanical properties of polymer brush systems make them ideal for further development as a novel surface coating to address biomaterial-associated infections.

Antimicrobial peptides (AMPs), otherwise known as host defence peptides (HDPs), are naturally occurring biomolecules expressed by a large array of species across the phylogenetic kingdoms. They have great potential to combat microbial infections by directly killing or inhibiting bacterial activity and/or by modulating the immune response of the host. Due to their multimodal properties, broad spectrum activity, and minimal resistance generation, these peptides have emerged as a promising response to the rapidly concerning problem of multidrug resistance (MDR). However, their therapeutic efficacy is limited by a number of factors, including rapid degradation, systemic toxicity, and low bioavailability. As such, many strategies have been developed to mitigate these limitations, such as peptide modification and delivery vehicle conjugation/encapsulation. Oftentimes, however, particularly in the case of the latter, this can hinder the activity of the parent AMP. Here, we review current delivery strategies used for AMP formulation, focusing on methodologies utilized for targeted infection site release of AMPs. This specificity unites the improved biocompatibility of the delivery vehicle with the unhindered activity of the free AMP, providing a promising means to effectively translate AMP therapy into clinical practice.